HomeMy WebLinkAboutWORK ACCEPTANCE FORM HOLESHOT PLUMBING - 23-00026 - Tropical Smoothie Cafe - RemodelContractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Holeshot Plumbing
Dale S Johnson
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83402
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2379 Heyrend Way
Address Line 2
dale@holeshotplumbing.org 2083171001
2083171001
Plumbing PLB-C-11517 11/30/2024 12,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00026 Tropical Smoothie
111 S 2nd West
Acceptance
Sign 1/19/2023